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Arrest of the Second Stage of Labor

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Arrest of the Second Stage of Labor

  • See Also
  1. Spontaneous Vaginal Delivery
  2. Assisted Delivery
  3. Failure to Progress (Labor Dystocia)
  4. Labor Dystocia Management
  5. Labor Dystocia Prevention
  • Definitions
  1. Arrest of second stage of labor
    1. No descent or rotation after a fixed time interval or pushing
  2. Protracted second stage of labor
    1. Slow rate of dilation and descent
    2. Nulliparous women
      1. Duration >3 hours (>4 hours with Epidural Anesthesia)
      2. Less than 25% of Nulliparous women will deliver vaginally after 3 hours of second stage
    3. Multiparous women
      1. Duration >2 hours (>3 hours with Epidural Anesthesia)
  • Exam
  1. See Leopold's Maneuvers (Fetal Position)
  • Complications
  • Prolonged Second Stage of Labor
  1. Maternal
    1. Chorioamnionitis
    2. Cesarean Section
    3. Perineal Laceration
    4. Postpartum Hemorrhage
  2. Fetal
    1. Neonatal Sepsis
    2. NICU Admission
    3. Shoulder Dystocia
  • Management
  1. See Active Management of Labor
  2. Occiput Posterior position (or Occipitotransverse Position)
    1. See Manual Rotation in Occipitoposterior Presentation
  3. Consider assisted Vaginal Delivery
  • References
  1. Dresang (2015) Am Fam Physician 92(3): 202-8 [PubMed]